Personal Independence Payments, welfare reform and the shrinking disability category

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The question of who counts and how we construct just who can ‘be disabled’ is central to our concerns in disability studies. As Stone makes clear, disability is exactly what a state deems it to be; the very malleable nature of the category has been exploited to widen or more commonly to narrow just who counts as disabled. This article will apply and adapt Stone’s thesis to current plans to revise the Personal Independence Payment extra costs benefit. Using official and disabled people’s narratives, the article will make clear the force with which new definitions of disability are being put forward. This process arguably risks doing state violence to a number of disabled people. These reforms have also used the language of independence in a way that fundamentally distorts the origins and potential of the term in an enabling society.

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... The UK government views those with a disability as entitled to social aid through the UK welfare system. However, a clear definition of 'disability', and thus who is entitled to such support, does not exist 'naturally', but rather has been described as an 'administrative category' defined by society, that continues to be redesigned and then enforced by subsequent governments (Roulstone 2015;Stone 1984). Therefore, changes to disability benefits in the United Kingdom can be defined as a political act and must be understood in the context of a range of different developments, some of which are specific to disabled people, while others relate to broader ideological or economic factors. ...
... In 2008 there was a severe global financial crisis and the UK government spent significant amounts on subsidising the banking sector. Such financial crises are often followed by what becomes defined as a crisis in social policy, and thus an opportunity to review welfare spending, including a review of the category of 'disability' (Roulstone 2015;Stone 1984). In 2010 the Coalition Government (Conservative and Liberal Democrat) introduced an austerity programme to curb public spending, which it has been argued is driven by the aim of radically reducing the overall level of public spending (Taylor-Gooby and Stoker 2011). ...
... The Independent Living Fund, which supported disabled people with high support needs to live independently, was closed in June 2015 for claimants in England and Wales, although not in Scotland and Northern Ireland, showing some divergence across the United Kingdom in terms of support for disabled people. Moreover, the implementation of existing policies (such as the introduction of the ESA) or the development of new policies, such as the replacement of Disability Living Allowance with the Personal Independence Payment (PIP), were all linked to planned cuts in overall spending on benefits (Roulstone 2015;Royston 2017). ...
This article documents the experiences of people with a physical health condition or disability who have experi- enced a loss of or change in disability benefits under the welfare reform programme in the United Kingdom. A theor- etical model was constructed using in-depth interviews and grounded theory methods. The findings show that par- ticipants experienced the benefits system as dehumanising, and felt that they lived in a judgemental and invalidating society, where they were perceived as ‘scroungers’ and faced discrimination from others. These experiences nega- tively affected their mental and physical health and well- being. They also negatively affected participants’ identity, leading to experiences of shame, hopelessness and social isolation. However, many participants attempted to resist these negative impacts (e.g. through seeking support or taking political action). The findings demonstrate the significant impact of benefit changes on well-being and identity, thus highlighting important implications for claimants, and staff in healthcare, the benefits system and government.
... I commence by discussing the meaning of Lyotard's (1984) 'performativity' and I make recourse to a trenchant analysis of sleep in late capitalism provided by Crary (2014) to explicate the link between performativity and disability. I then explore the historical development of the disability category in the 20th and 21st centuries, drawing on Stone's (1984) classical work, updated by Roulstone's (2015) more recent analysis of the impact of neoliberalism since the 1980s. The next section complicates matters by highlighting the contradictory impact of neoliberal performativity on the disability category, where the latter's administrative shrinking has been complemented by its market-based expansion. ...
... The push towards the shrinking of the disability category reached a new high in the aftermath of the 2008 financial crises. Alan Roulstone (2015) has discussed these processes in his analysis of recent disability benefits reforms in the United Kingdom, but similar trends have been observed in other countries as well (e.g. Brennan et al., 2016). ...
... In this world, the 'privilege' that Stone referred to has simultaneously eroded and transmogrified into an instrument of performativity. On the one hand, medicalised systems for disability assessment have tightened eligibility requirements (Roulstone, 2015); on the other hand, technologically mediated performance management systems, complemented by emerging 'perfectibility' markets, have extended the framing of people as 'deficient bodies and inefficient resources' (Mladenov, 2011) to the whole of the population. ...
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This article explores critically the relationship between capitalist performativity and the disability category. It draws on Jean-François Lyotard’s analysis of postmodernity to define ‘performativity’ as the principle of performance enhancement governing the world of contemporary techno-capitalism. The analysis then traces the historical development of the disability category in the 20th and 21st centuries and explains its complex interlinking with performativity. Special attention is paid to the impact of neoliberalism since the 1980s that includes both the disability category’s administrative shrinking and its market-based expansion. These theoretical and historical reflections are supplemented by a reading of Terry Gilliam’s movie The Zero Theorem. The conclusion discusses some possibilities for resisting performativity, suggested by the disability studies perspective espoused in the article.
... The WCA (2008) and PIP assessment (2012) need also to be understood as instrumental policy responses to political, economic and cultural forces, which acted to constrict the administrative category of disability both in the UK (Roulstone, 2015;Shakespeare et al, 2017) and across OECD countries (OECD, 2010). In earlier decades, during periods of national economic strength and full employment, the contestation of disability benefits was relatively limited. ...
... In earlier decades, during periods of national economic strength and full employment, the contestation of disability benefits was relatively limited. However, this consensus weakened throughout the 1990s, and the 2000s witnessed overt ministerial linking of disability benefits to inauthentic claimants and a 'culture of dependency' (Roulstone, 2015). Media representations of benefit claimants as 'shirkers and scroungers' (Garthwaite, 2011) popularised the image of counterfeit claimants within a broader political-cultural economy that saw social security systems as a prime lever of social, economic and moral deterioration (Jensen and Tyler, 2015). ...
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Background: Anti-welfare narratives depict welfare systems as overly-permissive, open to fraud, and fundamentally unfair. Countering these supposed ills have been political appeals to evidence and reforms made to disability benefit assessments under the banner of objectivity. But objectivity is a complex construct, which entails philosophical and political choices that tend to oppress, exclude and symbolically disqualify alternative perspectives. Aims and objectives: To examine reforms made to UK disability benefits assessments in the name of objectivity. Methods: Thematic analysis of 50 in-depth qualitative interviews with UK disability benefit claimants. Findings: Reforms made in pursuit of procedural objectivity reproduce existing social order, meaning claimants without personal, social and economic resources are less likely to succeed. Data reveal an increasingly detached and impersonal assessment process, set against a broader welfare landscape in which advocacy and support have been retrenched. In this context, attaining a valid and reliable assessment was, for many, contingent upon personal, social and economic resources. Discussion and conclusions: Political appeals to evidence helped establish an impetus and a legitimising logic for welfare reform. Procedural objectivity offers superficially plausible, but ultimately specious, remedies to longstanding anti-welfare tropes. Despite connotations of methodological neutrality, procedural objectivity is not a politically neutral epistemological standpoint. To know disability in a genuinely valid and reliable way, knowledge-making practices must respect dignity and proactively counter exclusory social order. These latter principles promise outcomes that are more trustworthy by virtue of their being more just.
... Thus, any restructuring of the benefits system, in the form of socalled welfare 'reform' that tightens up eligibility and/or reduces benefits (amount, reliability), can have profound impacts on these alreadybounded geographies (DeVerteuil et al., 2002;Power, 2014). An existing literature on the overall reach of reforms and their impact for health and health inequalities Gewurtz et al., 2019;Pearce, 2013;Schrecker and Bambra, 2015;Warren et al., 2014) has also focused on impacts to particular vulnerable populations in specific places, including those in the UK receiving 'out of work' sickness benefits (Barr et al., 2015a,b;Garthwaite, 2014;Garthwaite et al., 2014), disability benefits (Mattheys et al., 2018;Power, 2016;Roulstone, 2015), and those being penalised by the bedroom tax (Moffatt et al., 2016). ...
... The evidence from the interviews lends credence to findings from other recent studies of benefits reform (Barr et al, 2015a,b;Garthwaite, 2014;Garthwaite et al., 2014;Gewurtz et al., 2019;Mattheys et al., 2018;Moffatt et al., 2016;Power, 2016;Roulstone, 2015;Warren et al., 2014): that the re-assessment process is not just flawed for people with mental health problems, but is actively damaging. There was substantial reflection on the part of service users that the assessment processes simply did not appear to regard them as people with particular needs, ones that perhaps could not always be 'seen'. ...
This paper presents the lived experiences of individuals with mental illness as they navigate the benefits landscape in an age of welfare reform in the UK. We focus on the impacts upon their well-being and daily geographies. We articulate the relationship between welfare reform and mental health using the concept of poverty management and its ‘missing geographies’, in which everyday well-being and routines are dismissed by the restructuring welfare system. We liken this dismissal to a shift towards a narrower and more unforgiving mode of poverty management, where even the smallest misstep can unravel the entire edifice of everyday survival and well-being.
... Jednocześnie jednym ze sposobów uniknięcia odpowiedzialności, a wręcz przekucia potencjalnej porażki w sukces, jest zmiana perspektywy oceny danego działania i dyskursu go dotyczącego. Przykładem z obszaru niepełnosprawności są cięcia świadczeń pieniężnych z tytułu niepełnosprawności, przedstawiane nie jako oszczędności, ale odbieranie nienależnych środków osobom, które mimo spełniania formalnych kryteriów, faktycznie nie są niepełnosprawne (Morris, 2016;Roulstone, 2015). Na całość problemu można też spojrzeć pod kątem wpływów myślenia neoliberalnego na politykę państwa i definiowania niepełnosprawności, a przy okazji dzielenia osób z niepełnosprawnościami na takie, które zasługują na bezwarunkową pomoc i te, które na nią nie zasługują, a przynajmniej nie bez prób ich aktywizacji w ramach rynku pracy (Grover, Soldatic, 2013;Mladenov, 2015;Roulstone, 2015). ...
... Przykładem z obszaru niepełnosprawności są cięcia świadczeń pieniężnych z tytułu niepełnosprawności, przedstawiane nie jako oszczędności, ale odbieranie nienależnych środków osobom, które mimo spełniania formalnych kryteriów, faktycznie nie są niepełnosprawne (Morris, 2016;Roulstone, 2015). Na całość problemu można też spojrzeć pod kątem wpływów myślenia neoliberalnego na politykę państwa i definiowania niepełnosprawności, a przy okazji dzielenia osób z niepełnosprawnościami na takie, które zasługują na bezwarunkową pomoc i te, które na nią nie zasługują, a przynajmniej nie bez prób ich aktywizacji w ramach rynku pracy (Grover, Soldatic, 2013;Mladenov, 2015;Roulstone, 2015). Podejście to, jak trafnie zauważa Mladenov (2015) stawia środowiska osób z niepełnosprawnościami przed dwoma trudnymi zadaniami. ...
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Monografia „Polityka publiczna wobec osób z niepełnosprawnościami” jest omówieniem w sposób syntetyczny uwarunkowań konstruowania polityki publicznej wobec niepełnosprawności. Analizuję w niej bariery, a także wskazuję na rozwiązania ułatwiające kreowanie takiej polityki publicznej, która uwzględnia złożoność i wielowymiarowość niepełnosprawności; zwracam uwagę na potrzebę zapewnienia osobom z niepełnosprawnościami pełni ich praw. Monografia stanowi syntezę moich dotychczasowych zainteresowań tematyką niepełnosprawności, a ujmując szerzej – problematyką związaną z procesem wykluczenia i włączenia społecznego grup mniejszościowych oraz rolą, jaką odgrywają w tym procesie instytucje publiczne. Należy zaznaczyć, że monografia powstała w szczególnym kontekście. U jej podstaw leży założenie, że polityka publiczna wobec niepełnosprawności i osób z niepełnosprawnościami ulega w ostatnich latach istotnym przekształceniom, co jest związane ze zmianą paradygmatu niepełnosprawności – z medycznego na społeczny. W paradygmacie medycznym kluczowa jest koncentracja na organizmie/ciele i deficytach jednostki, która poprzez swoją niesprawność i ograniczenia odbiega od normy. Celem działań instytucji publicznych, ale też i samej OzN, powinny być możliwie pełna rehabilitacja i przywrócenie do tej normy. W podejściu społecznym punkt ciężkości opiera się na potencjale i możliwościach jednostki, a ograniczenie sprawności jest traktowane jako normalny element życia. Kluczowe bariery nie wynikają z ograniczeń tkwiących w OzN, lecz raczej tych istniejących w środowisku społecznym. Na zmianę podejścia do niepełnosprawności miały przede wszystkim wpływ działania środowisk osób z niepełnosprawności i ich aktywność polityczno-społeczna, a kluczowym dokumentem będącym jednocześnie drogowskazem, co do oczekiwanego kierunku polityki jest Konwencja o prawach osób niepełnosprawnych (dalej też: KPON). Celem Konwencji, zgodnie z art. 1 „jest popieranie, ochrona i zapewnienie pełnego i równego korzystania ze wszystkich praw człowieka i podstawowych wolności przez wszystkie osoby niepełnosprawne oraz popieranie poszanowania ich przyrodzonej godności.” Istotną rolę w zmianie obowiązującego paradygmatu odegrały też przemiany społeczno-demograficzne związane ze starzeniem się ludności oraz przekształceniami więzi społecznych czy rosnącymi aspiracjami zawodowym kobiet i malejącym potencjałem opiekuńczym rodziny. Przemiany te powodują, że rośnie rola instytucji publicznych, które w szerszym zakresie coraz częściej uzupełniają lub zastępują rodzinę we wspieraniu OzN w życiu codziennym. Zwiększająca się liczba osób z niepełnosprawnościami sprawia też, że na znaczeniu zyskuje potrzeba szukania nowych, bardziej efektywnych rozwiązań na rzecz wspierania niezależnego życia osób z niepełnosprawnościami. Przygotowana przeze mnie monografia stanowi element tych poszukiwań i kolejny głos w dyskusji. Mamy do czynienia z wyjściem niepełnosprawności ze sfery prywatnej, a kwestię tę można rozwiązać tylko w ramach działań politycznych, które miałyby na celu transformację istniejącego systemu wsparcia. Polityka publiczna wobec osób z niepełnosprawnościami jest więc obszarem, gdzie stary paradygmat – przynajmniej na poziomie deklaratywnym – został zastąpiony nowym. Wciąż istnieją jednak programy publiczne tworzone w poprzednim paradygmacie oraz instytucje o charakterze segregacyjnym, które nie przystają w pełni do nowego podejścia, stawiającego większy nacisk na włączanie OzN w życie społeczne. Widać też napięcia i bariery we wdrażaniu poszczególnych wyborów programowych związanych np. z edukacją włączającą czy włączającym rynkiem pracy. Rozbieżności między deklaracjami politycznymi, obowiązującym prawem a praktyką życia codziennego oraz chęć zrozumienia mechanizmów stojących za porażką niektórych rozwiązań oraz trwałością istniejącego status quo są powodami mojego zainteresowaniem tematyką niepełnosprawności. Łącząc aktywność naukową i działalność społeczną, starałem się poznać kluczowe problemy napotykane przez osoby z niepełnosprawnościami oraz ich bliskich, zrozumieć przyczyny, a docelowo zaproponować kierunek zmian i konkretne rozwiązania. Za swoje osiągnięcie uważam użycie w dyskursie o niepełnosprawności koncepcji spodziewanej porażki, czyli sytuacji, w której wprowadza się dane rozwiązanie, nie licząc na jego sukces. Moim wkładem jest także analiza procesu powstawania poszczególnych programów publicznych adresowych do osób niepełnosprawnych – z odwołaniem się do teorii z zakresu polityki publicznej, np. „okien możliwości”. Zwracam również uwagę na problem fasadowości i pozorność wielu działań w ramach tej polityki, co wiąże się zarówno ze spodziewaną porażką, ale też chęcią uniknięcia odpowiedzialności za niektóre rozwiązania. Takim przykładem są np. różnego rodzaju zespoły robocze mające w teorii wypracować nowe rozwiązania, a w praktyce będące elementem kanalizacji nastrojów społecznych i wykazania, że podjęto jakieś działania na rzecz zmiany istniejącego systemu. Podkreślam także potrzebę społecznego legitymizowania działań publicznych, między innymi poprzez system reprezentowania interesów środowiskowych i negocjowania konsensusów z władzą publiczną. W monografii zaproponowałem chronologiczne podejście do uregulowań prawnych, co pozwoliło na prześledzenie podobieństw pomiędzy różnymi instytucjami w nastawieniu do problematyki niepełnosprawności i wskazanie, jak zmieniało się samo definiowanie zjawiska i obszary podlegające regulacjom w ostatnich kilkudziesięciu latach. Warto podkreślić, że choć kwestia niepełnosprawności staje się coraz bardziej wielowymiarowa, to są też problemy, które pojawiają się stale, jak na przykład dostęp osób z niepełnosprawnościami do rynku pracy. Za nowatorskie wobec istniejącej literatury przedmiotu uważam podejście, w którym zestawiam politykę publiczną z trajektorią niepełnosprawności rozumianą, jako załamanie się dotychczasowej biografii na skutek nabycia niesprawności i zderzenia się z barierami istniejącymi w środowisku, co często wiąże się z wykluczeniem społecznym. Ważne jest, na ile udaje się takim osobom przełamać trajektorię, co w praktyce oznacza likwidację bądź znaczne ograniczenie wpływu różnego rodzaju barier środowiskowych. Jednocześnie analizuję, co może stanowić punkt zwrotny w trajektorii niepełnosprawności i jaką rolę w procesie wykluczania społecznego bądź przełamywania ograniczeń odgrywa istniejący system wsparcia. W opracowaniu wyróżniam także rzadko poruszany w literaturze okres przed narodzinami oraz proces umierania; tym samym odnoszę się do dwóch kontrowersyjnych zagadnień, jakimi są aborcja i eutanazja. Kontrowersje te są związane z rozumieniem prawa do życia i potencjalnym konfliktem wynikającym z prawa do decydowania o własnym życiu. Jednym z efektów rozważań nad przebiegiem życia OzN jest wskazanie okresu dorastania jako tego, w którym w największym stopniu widać przewagę polityki prowadzonej w oparciu o paradygmat społeczny, a nie medyczny. Dorastanie uwypukla bowiem rolę barier – tych miękkich, związanych z postawami i twardych: architektonicznych, tkwiących w środowisku zewnętrznym, a nie w osobie z niepełnosprawnością. W pracy poświęcam też miejsce na przyjrzenie się barierom instytucjonalnym i roli tzw. biurokracji pierwszego kontaktu. Widoczna jest tu uporczywość występowania i powracania wielu typów problemów oraz ograniczone efekty podejmowanych działań, a jedną z przyczyn jest opór instytucjonalny przed zmianą podejścia do osoby z niepełnosprawnością. W monografii wskazuję również na kluczową rolę środowisk osób z niepełnosprawnościami w kreowaniu i recenzowaniu polityki publicznej wobec niepełnosprawności oraz czynniki, takie jak istnienie organizacji mogących pełnić funkcję reprezentanta i rzecznika środowiska OzN, które mogłyby wpłynąć na zwiększenie szans na kreowanie agendy politycznej przez osoby z niepełnosprawnościami. Zwracam uwagę, że KPON poza wieloma efektami pozytywnymi może być także przeszkodą w kreowaniu polityki, bowiem wymaga tzw. inteligentnej, wielosektorowej polityki społecznej i sprawnych instytucji publicznych oraz narusza pozycję istniejących już instytucji o charakterze segregacyjnym. Tym samym sprzyja pozorowaniu działań i prowadzeniu polityki w kontekście oczekiwanej porażki, a tym samym utrzymywaniu status quo. Istotnym, choć pewnie dyskusyjnym, elementem monografii jest także opowiedzenie się za określoną rolą badacza w kształtowaniu polityki publicznej wobec osób z niepełnosprawnościami. W książce argumentuję, że badacz analizując życie codzienne OzN i politykę wobec nich, a przy tym nie rezygnując z akademickich standardów badań, powinien być jednocześnie ich sojusznikiem i partnerem, a nie zdystansowanym obserwatorem.
... Notably, this number represents fewer than one-fifth of the 12 million disabled people living in the United Kingdom (DWP, 2017). Since the late 1990s, there has been ongoing policy rhetoric in the United Kingdom against fraudulent disability claimants, which intensified under the Conservative/Liberal Coalition Government that came into power in 2010 and the Conservative Government that followed in 2015 (Roulstone, 2015). There have been growing public and political sentiments that generous government benefits and open eligibility fostered welfare dependence (Roulstone, 2015). ...
... Since the late 1990s, there has been ongoing policy rhetoric in the United Kingdom against fraudulent disability claimants, which intensified under the Conservative/Liberal Coalition Government that came into power in 2010 and the Conservative Government that followed in 2015 (Roulstone, 2015). There have been growing public and political sentiments that generous government benefits and open eligibility fostered welfare dependence (Roulstone, 2015). Over the last few years, the U.K. government has proposed a series of cuts to its disability benefits. ...
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The present study examined the economic well‐being of disabled and nondisabled men and women in the United Kingdom. Using the 2009–2014 Life Opportunities Survey (N = 6,159 adults), the study is the first longitudinal study to empirically compare the economic well‐being of disabled women in contrast to disabled men and nondisabled men and women. Hierarchical linear modelling and hierarchical linear logistic modelling were used to estimate the longitudinal changes. Findings indicate that, overall, disabled women's economic well‐being improved significantly between 2009 and 2014 even after controlling for other demographic characteristics. However, the improvements were not substantial enough to significantly narrow the economic disparities between disabled women and disabled men and nondisabled men and women. Disabled women remained worse off than disabled men and nondisabled men and women in 2014 as they did in 2009. The findings indicate that intersectional discrimination against disabled women exist in the United Kingdom. Findings from this study provide empirical evidence to support policies that enhance the economic security of disabled women.
... The politics of austerity underpinned this, with the desire to save money and reduce the number of disability benefit claimants; between 2003 and 2012 the number of people claiming DLA increased from 2.5 million to 3.2 million, at a cost of £12.6 billion per annum. Royston (2017, 9) fears that PIP prioritises 'reduction in provision over the effectiveness of reform' and leads to a 'shrinking disability category' (Roulstone 2015). ...
... Previous analysis has identified a similar range of psychological responses which can be associated with claiming disability benefits in the UK (boardman 2020). Furthermore, it is clear that the participants in this research have been negatively impacted by the shifting construction of disability that has taken place over the last decade (Roulstone 2015); the recent programme of welfare reform has allowed the UK government to redraw the boundaries of how the state defines disability. In our research, this was most powerfully demonstrated when Dennis stated: 'I was made to feel like I wasn't disabled anymore'. ...
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This paper examines the impact of major social security reform on mental health claimants by analysing the transition to Personal Independence Payment in the UK. Personal Independence Payment was introduced in April 2013, replacing Disability Living Allowance as the main non-means tested disability benefit intended to assist with the additional costs associated with disability or long-term health conditions. It is important to gain a better understanding of how people with mental health problems have experienced this reform. Twelve service users were interviewed for this qualitative research. Analysis identified three main themes: problems with the Personal Independence Payment claims process; problems conveying mental health problems during the assessment process; and positive experiences associated with the transition to Personal Independence Payment. This research demonstrates that major changes in benefit policy are challenging for people with mental health problems, particularly when delivered in a climate of austerity. • Points of interest • The UK Government has changed the main disability benefit for disabled adults. From April 2013, Disability Living Allowance (DLA) has been phased out and replaced by Personal Independence Payment (PIP). • This research found that this significant change caused difficulties for people with mental health problems. • Everyone who took part reported increased anxiety, problems with claiming PIP, communicating with benefit officials and the medical assessment. • It is important to learn from these problems so that future benefit changes, both in the UK and in other countries, can be developed and rolled-out in ways which are more appropriate for people with mental health problems.
... According to Garthwaite (2011), the process of face-to-face consultations has the potential to both reinforce a medical model of disability and to portray some disabilities or illnesses as deserving of welfare, whilst others are not. As disability is always a social construct (Moraes, 2012), by altering benefit criteria, the government can redefine individuals' entitlement to support and ergo citizenship (Briant et al., 2013;Roulstone, 2015). As fraud levels are low amongst those claiming disability benefits, reclassifying some disabled people as non-disabled (or not 'disabled enough') is seen as a necessary measure to ensure required cost reductions (Briant et al., 2013;Goodley et al., 2014). ...
... Online activism, for example, tends to mobilise around particular issues for a limited-time (perhaps occurring simultaneously with policy changes) as opposed to operating for the long term (Trevisan, 2017b(Trevisan, , 2018 While for Rachel, blogging provided her with a platform through which to communicate her message to the public realm, as outlined in section 3.7, posting on social media can bring about several risks in the current environment of online surveillance (Van Dijck, 2013). In the current climate of austerity, disabled people find themselves constantly under scrutiny (Burke and Crow, 2017;Garthwaite, 2011), with narrow understandings of what constitutes a disability, how it should look and how disabled people should act (Grover and Piggott, 2010;Roulstone, 2015). ...
With the onset of austerity, disabled people in the United Kingdom have faced a sustained period of financial cuts, including cuts to personal income, social care and advocacy organisations. Many individuals have found themselves in increasingly precarious situations, having to rely increasingly on non-statutory, more informal structures of care. Disabled people, however, have not accepted these changes in silence but have often been vocal in their opposition to these cuts. Opposition and resistance can be seen through increased lobbying, the establishing of disability anti-austerity protest groups and the emergence of numerous online campaigns. Austerity has been accompanied by a recent growth in disability activism, as individuals find ways of resisting and coping under increasingly difficult conditions. To date, there has been very limited documentation or analysis of the political struggles of disability activists during a time of austerity. Through adopting a qualitative approach, this study examines the lives of those involved in disability activism, and the places in which their activism is enacted. The findings are drawn from 27 biographical interviews and participant observation at 13 disability activist events. Rather than being a representative study, this research seeks to provide a deep and nuanced insight into the lives of a small number of disabled people who are engaging in activism in response to austerity. It is hoped that this thesis will serve as a form of activism in itself, as a space in which stories can be both shared and heard and used as a possible resource for future generations.
... On the contrary, direct payments were a collectively inspired means of supporting the rights and liberation of service users'. Reactions against marketisation of 'independence' have intensified in the era of post-2008 austerity (Roulstone 2015). Moreover, historical analysis has suggested that: over the last three decades the demands of the DPM [disabled people's movement] … have been 'resignified' and, similarly to the demands of second-wave feminism, have been appropriated to serve the interests of capital in its historically renewed, neoliberal form. ...
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This article presents the results of a survey on personal assistance (PA) for disabled people, conducted among PA users and members of the independent living movement in Europe. The survey was developed and implemented in the spirit of emancipatory disability research, and was informed by the social model of disability and the independent living philosophy. Participants were asked to assess a series of characteristics of PA in terms of their impact on users' choice and control. Their responses help identify which characteristics of PA are considered to be enablers of choice and control, which characteristics are perceived as barriers and which characteristics elicit disagreement or lack of consensus among PA users and members of the independent living movement in Europe. Plans for using the results of the survey to develop a tool for evaluating PA schemes are also discussed.
... As argued by Stone (1984), the distinction between 'disabled' and 'able-bodied' is political, economic, and historical -in times of strong welfare-state arrangements, there is less need to make recourse to the disability category in order to cope with life and to escape poverty and exploitation. However, the distinction becomes more contested and, accordingly, more violently policed in times of economic turmoil and welfarestate retrenchment (see also Roulstone, 2015). ...
... Physical education of students with disorders of muscular skeletal apparatus (MSA) is regarded by specialists as pedagogic process, oriented on development of main and specific motor abilities, perfection of vitally important motor skills. On this base motor actions' technique is formed as well as moral-will sphere of disabled people is developed (Phelan, & Kinsella, 2014;Baril, 2015;Roulstone, 2015). As a result assessment of life quality is risen жизни (Duvdevany, 2010;Bolach, Prystupa, 2014;Makarova, 2014). ...
Purpose: development of approaches to improvement of coordination abilities of students with muscular skeletal apparatus disorders under influence of system of exercises and games with ball. Material: in the research students with disorders of muscular skeletal apparatus (n=63, 16-19 years' age, boys and girls) participated. The research was being carried out during 1.5 years (3 academic semesters). The students had disability of light and average degree. All they were under doctor's supervision and did not have counter indications to physical education. Coordination abilities were tested by attempts to get in target (vertical and horizontal) by ball and by movements' differentiation by power and space characteristics. Results: we provided approaches to improvement of students' physical fitness and to acquiring new motor skills and abilities, required for adaptation to everyday life. Characteristic feature of changes of applied forces' coordination is repeated mistake of their increasing. Assessment of space orientation showed underestimation of bio-kinematic links' correlation. It was found that the most effective motor functioning rehabilitation mean was worked out by us system of exercises and games with ball, the weight of which changed depending on the tasks to be solved. Exercises and games with small ball turned out to be the most effective for improvement of coordination. They ensure development of fine motor abilities and are the most accessible in space time and power perception of load. Conclusions: The conducted research witnesses about positive influence of exercises and games with ball on students' coordination abilities. We worked out system of specially selected exercises and games with ball for improvement of motor fitness and motor accuracy of students with disorders of motor muscular apparatus.
... Such stringent measures in the assessment of PIP raise ethical concerns for how our society conceptualises 'disability'. Unlike ethnicity, sex and gender, disability is a complex concept in social policy that has the propensity to exclude the most vulnerable people of our society, given the interplay of objective, subjective, official and personal constructions of disability (Roulstone, 2015). Council, 2012). ...
... In the UK, these public spending cuts are associated with wider social security 'welfare reforms' which have redrawn the boundaries of eligibility for disability-related and other social benefits (Roulstone 2015). The restriction of access to support (benefits and/or services) is coupled with an increased articulation of notions of deservingness, particularly linking disability to 'vulnerability' with the implications a continual theme within social policy research e.g. in relation to stigma and identity (Brown 2012). ...
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In the aftermath of the 2008 financial crisis many countries embarked on a prolonged period of public sector ‘austerity’ which for some included seeking dramatic reductions in social security spending. It is in this context that the research investigates the negative impacts of interactions with the UK disability benefits system on the lives of disabled people. The research uses in-depth semi-structured interviews and a focus group to study the experiences of 49 people who either had an impairment or chronic health concern and/or were family carers for an adult or child with these concerns. The analysis identified four aggregate dimensions evidenced by the transcript data: harmful health and well-being consequences, negative financial and resource impacts, perverse employment effects and wider social disability concerns. These dimensions highlight how interactions with ‘social security’ policy in the contemporary context can have harmful, iatrogenic consequences for disabled people and their families.
... In the wider social context the study is conducted at a time when the impact of austerity has resulted in HIV support services being cut or decommissioned and there are an increasing number of accounts in the media of people with cancer finding it difficult to access financial support through Personal Independence Payments (PIP) (Roulstone, 2015). An exploration of dual diagnosis experiences at this time may provide some insight into the impact of these structural influences on peoples' lives. ...
Conference Paper
BACKGROUND: As the number of people living with HIV increases due to the combination of effective treatment and continued HIV incidence, a growing number will experience a cancer diagnosis. This thesis explores patients’ experiences of a dual diagnosis of HIV and cancer. // METHODS: Three studies were conducted comprising: (i) an analysis of popular discourse about HIV and cancer in free London newspapers from 2012-2017 (ii) semi-structured longitudinal interviews with 17 patients with a dual diagnosis (iii) a focused ethnography of seven participant observations and seven informal interviews with healthcare professionals. // FINDINGS: Popular representations of cancer from the newspaper analysis depict it as a condition that could happen to anyone and deserving of sympathy whilst HIV retains negative and stigmatising connotations linking it to social deviance, blame and shame. The interview data revealed two conditions both with a powerful impact. Although HIV could be well managed on simple treatment it wielded an enormous influence over people’s lives in the form of felt stigma which meant that individuals were engaged in constant work to manage information and avoid blame and rejection. Cancer could provide an opportunity to share and get support for the first time but its physically debilitating treatment and uncertain outcome caused fear and anxiety which was exacerbated by people’s lack of fit with the cancer services. The deeply personal nature of a HIV diagnosis was not well understood by oncology healthcare professionals and not always accommodated within cancer care. // CONCLUSIONS: Patients with this dual diagnosis are uniquely vulnerable; a better understanding of their experiences is essential for cancer services to provide good patient centred care.
... Accordingly, the rehabilitative goals of welfare and penal policy have been eroded and more punitive orientations have taken centre stage. While the exercise of coercive measures by the state to engender labour market participation is nothing new, the austerity phase of neoliberalism has heralded a concerted effort to enforce such compliance across much wider populations, simultaneously rolling back levels of welfare support to those groups previously regarded as exempt from the labour market (Roulstone, 2015). Processes of disciplinary proletarianisation are buttressed by the deployment of stigmatisation. ...
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The case studies that will be presented in this book illustrate the extent to which a ‘punitive turn’ across a number of policy domains is a prominent and pervasive feature of neoliberalism in the UK. However, before we turn to these examples of policy implementation, this first chapter will outline a broader understanding of this phenomenon and its implications for activist strategy. Consequently, the chapter has two main aims. The first is to locate these punitive tendencies as a feature of the ‘integral’ state under contemporary neoliberalism, which utilises increasingly draconian and divisive means to maintain a degree of legitimacy for this system. These threats to consent-making processes are an effect of neoliberal reconfigurations of the interrelated spheres of production and social reproduction that underpin harmful and detrimental processes such as work intensification in the former and crises of care provision in the latter. However, neoliberal reforms have also resulted in demographic shifts both within labour markets and across society more widely that are engendering new patterns of contestation and resistance. Our second major aim in the chapter is, therefore, to explore the strategic implications of these shifting contexts and demographics for strategies of resistance and the development of oppositional currents and coalitions. In particular, and building on our analysis of these shifts, we propose a framework for activist strategy which we call the ‘integrative transitional’ approach (ITA). ITA takes account of these wider changes in social conditions by incorporating political demands that span productive and reproductive concerns and in so doing, we argue, has the potential to enhance activist efforts to build and strengthen diverse and broad-based alliances of resistance to punitive state-corporate policy agendas.
... Examples include the 2010 Coalition government's below inflation uprating of benefits, followed by a benefit rates freeze under the 2015 Conservative administration (Beatty & Fothergill, 2016). Another is the restriction of access to cash benefits by redrawing eligibility boundaries, for instance the Coalition government's prediction in 2013 of an eventual one quarter reduction in those eligible to access the disability benefit Personal Independence Payment (PIP) when it replaced Disability Living Allowance (DLA) (Roulstone, 2015;Kennedy, 2017). ...
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This chapter offers an account of the emerging mental health survivor-led social movement against psychocompulsion. It begins with narratives describing the authors’ journeys into activism around these issues. This is followed by an overview of recent welfare ‘reforms’ and shifts in mental health policy and practice in the UK against which activists are organising. It goes on to describe activists’ collective responses and interventions to challenge these policy agendas, noting developing alliances and strategies of resistance. The chapter concludes by briefly examining emergent debates and policy issues for the movement.
... Adopted by OECD countries, such as the United Kingdom and Australia, work capacity assessments are mechanisms for implementing economic rationalism policy and concepts of new paternalism and deservingness. The assessments are designed to categorise, code, and sort people with disabilities according to their capacity to work with intervention and the amount of work hours one can perform (Garsten and Jacobsson 2013;Roulstone 2015;Shakespeare et al. 2017). This has become standard practice regardless of the appropriateness, effectiveness, and accuracy of such practices. ...
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Young adults with disabilities are a specific target of the welfare-to-work policy introduced by many OECD countries over the past decade. The implementation of these policies is a significant concern for service delivery organisations and advocates in Australia and internationally due to complex intersecting structural barriers that persist for many young adults with disabilities. A particular focus of this article is work capacity assessments. Drawing on socio-political theories and interpretive policy analysis, the 22 in-depth interviews with personnel from service delivery organisations and advocacy organisations reveal how the deemed capacity to work process is not only interpreted as flawed, but the current policy approach disables young adults, perpetuates stigma, and creates division between service users and service providers. The accounts reinforce the need to contest such assessments and instead turn towards a rights-based capability approach permitting young adults with disability self-determination over their education-to-employment pathway.
... Wider societal changes include the positive -internet dating and better access (Löfgren-Mårtenson 2008) -and the negative -austerity and worsening social support (Roulstone 2015). In particular, greater openness towards sexuality diversity and sexual expression may open up more choices for disabled people -as the testimony of Jenny highlights (Hollomotz, 2013). ...
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This paper follows up on qualitative interviews conducted with British disabled people in 1994–6, exploring how people’s lives and relationships have changed over twenty years (n = 8). The themes include imagery and identity, access to relationships, social context and attitudes. Ageing brought greater self-acceptance, and also lower salience of impairment; but for some, it also brought co-morbid chronic health issues which made life more complicated. Respondents generally felt that social attitudes to disabled sexuality had not changed sufficiently, but also that UK austerity policies risked undermining hard-won independence and wellbeing.
... The introduction of Personal Independence Payments (PIP) in 2013 fundamentally changed disability assessments and redrew the boundaries of what (and who) is considered disabled. This is a striking example of how the social construction of disability is manifested so explicitly in policing what, officially, 'counts' as disability (Roulstone, 2015). In practice, PIP claimants fill in a questionnaire about activities of daily living entitled 'how your disability affects you' (DWP, 2021a), which healthcare professionals (HCPs) use during a semi-structured PIP assessment interview to evaluate their eligibility for PIP on a nine-point scale. ...
... This led many disabled people being redefined as fit for employment which, rather than an act of empowerment, in reality meant the withdrawal of the welfare support (Wright, 2012;Baumberg, 2015) that was vital to live independently. This was further exacerbated by the reform of 'personal independence payments' which again included a major reassessment process that some scholars have evaluated as a form of 'state violence' towards disabled people in the UK (Roulstone, 2015) that has caused not only pain and distress to individuals but also the demonization and scapegoating of disabled people in society (Ryan, 2019). In response, organizations which form the disabled people's movement in the UK have sharply criticised the policies and discourses of austerity and welfare reform. ...
This article examines collective action and the alliances between social movement organizations engaged in the work of solidarity with disabled people within and across borders during austerity. Building upon social movement theory, specifically political opportunities (Eisinger, 1973; McAdam, 1996) and resource mobilisation (McCarthy and Zald, 1977), we focus our analysis on data from in-depth interviews with thirty-five organizations at the UK and European levels, where we examine both how solidarity is operationalized by such organizations and the everyday cooperation and alliances they build with others in a UK policy context that has been hostile to disabled people (Bambra and Smith, 2010; Garthwaite, 2014) and a European context which disabled people's solidarity organizations have sought to seize as political opportunities. Our study therefore adopts a multi-level approach by analysing the building of alliances between organizations at the local, national and transnational levels and it reveals the impact of the political context and organisational pressures which can diminish resources and generate competition, thus placing strains on solidarity between disabled people. 2
... He knew that employers must make reasonable adjustments and had thought about physical access to his work place (see Critten, 2016) but he had not thought about the hours he would have to work and the effect this would have on him physically (see Logiudice, 2016). Many people with disabilities may not be able to find fulltime employment, or their condition stops them from being permanently employed (Roulstone, 2015). There is much pressure given to young people with a disability to find paid work (Barnes and Mercer, 2005) but it is possible that this is unrealistic. ...
This chapter focuses on the transition between education and the employment of young people with a disability. Governments produce guidelines and legislation which are designed to ensure that people with disabilities are able to find employment. Programmes for the transition of students with a disability are designed and carried out by educational establishments and services such as Connexions. However, the case study of Nick illustrated the differences in the guidance given throughout his transition into employment, and he questioned aspects of government legislation which he felt were unhelpful to people with disabilities and, ultimately, to employers. The implications of his experiences are discussed with reference to transition guidance, to government legislation and to the personal and emotional cost to people with a disability.
... They contained a smörgåsbord of interwoven reforms, many of which clustered around low-income working age households. The former introduced eight large-scale reforms, including the introduction of Universal Credit (a reform designed to 'subsume' a number of preexisting working age benefits together, affecting millions of families) (Royston 2012), Personal Independence Payments (a wide-reaching reform to payments to support the costs of disability by replacing Disability Living Allowance) (Roulstone 2015), and the Benefit Cap (a 'limit' for the total amount of working-age benefits a household can receive). 1 The latter reduced the level of the Benefit Cap, introduced the 'two-child limit' in Child Tax Credit/Universal Credit (O'Brien 2018), and introduced various benefit freezes, abolitions, and conditionality. ...
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Notwithstanding its central place in social security policy-making and in the experiences of those on the receiving end of welfare reforms, cumulative impact is an under interrogated and theorised problem in social welfare scholarship. This paper seeks to address this in two ways. First, it draws on the lessons of the comparatively well-developed literature on cumulative impact in environmental studies to: (i) identify different dimensions of cumulative impact and (ii) best practices in undertaking cumulative impact assessments. Second, it argues that having regard to cumulative impact is not just good policy-making, but is also a legal obligation. To discharge the “Public Sector Equality Duty” under s.149 Equality Act 2010, a public authority needs to have due regard to clear cumulative impacts between measures. In the context of social security policy-making, a failure to undertake enquiries to establish cumulative impacts between polices is likely to breach the PSED. Drawing on examples from the UK Government’s Welfare Reform Act 2012 and the Welfare Reform and Work Act 2016 throughout, the paper makes the case for both the importance of addressing cumulative impact in policymaking, and the need for greater interrogation by social welfare scholarship.
... Indeed, two-thirds (n=68) of the blog posts analyzed for this study made at least one explicit reference to a specific impairment. However, the vast majority presented a wide range of impairments -from mobility problems to mental health issues such as clinical depression -to illustrate the complexity of disability and debunk the simplistic categorization used in policy and media narratives to justify the curtailment of state welfare for disabled people (Roulstone 2015). Furthermore, only 17 of these posts implied a sense of tragedy or hopelessness. ...
This article sheds light on the emergent advocacy technique of building policy counter-narratives by crowd-sourcing, organizing, and disseminating personal life stories online. Focusing on the case of disability rights groups in the United Kingdom, this article uses qualitative in-depth content analysis to examine 107 blog posts containing personal disability stories published in 2012–2013 by two anti-austerity groups. Although each of these groups managed its blogs differently, with one carefully curating stories and the other publishing crowd-sourced narratives without any form of editing, they generated virtually identical counter-narratives. These accounts challenged the dominant news narrative that presented disability welfare claimants as ‘cheats’ and ‘scroungers’. They did so by retaining the overarching structure of the dominant narrative – which functioned as the de facto coordinating mechanism for the crowd-sourced counter-narrative – and replacing its content with three alternative arguments drawn from personal life stories. The implications of this new advocacy technique for disabled people and other marginalized groups are discussed. This includes considerations about the development of a form of story-based advocacy that is both effective and respectful of the people who ‘lend’ their lived experiences for advocacy purposes. This article concludes by highlighting the need for research to investigate whether the new voices that emerge through these processes are ‘being heard’ and can successfully re-frame public discourse about sensitive policy issues.
... And through the development of a more 'personalised' employment support programme there is a danger that the use of conditionality and sanctions will be extended to a larger number of disabled people. This is a troubling development as it is premised upon the notion that disabled people are workless because of supply-side factors (their attitudes and character), rather than the demand for their labour power and the idea that 'faux' disabled people are swelling the 'disability category' when they could be self-supporting through wage work (Roulstone 2015). Complex systems which force people from 'welfare to work' are always a problem, particularly at an individual level. ...
In October 2016 the newly appointed UK Secretary of State for Work and Pensions, Damian Green, announced that some disabled people receiving Employment and Support Allowance would not face reassessment for their financial support to continue. This article critically engages with this announcement in the context of the publication of Improving Lives. The Work, Health and Disability Green Paper shortly afterwards.
... Examples include the below inflation uprating of benefits under the 2010 Coalition government, followed by freezing of benefit rates under the 2015 Conservative administration (Beatty & Fothergill, 2016). Another is the restriction of access to cash benefits by redrawing eligibility boundaries, for instance the Coalition government's prediction in 2013 of an eventual one quarter reduction in those eligible to access disability benefit Personal Independence Payment (PIP) when it replaced Disability Living Allowance (DLA) (Roulstone, 2015;Kennedy, 2017). ...
Technical Report
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This EU Horizon 2020 funded study examines the impact of welfare reform on claimants with mental health needs in England, in particular the effects of the recent introduction of two social protection measures: Employment and Support Allowance (ESA) and Personal Independence Payment (PIP). Our analysis indicates that reduced access to and adequacy of benefit coverage under these reforms, particularly the elements linked to increased conditionality, have led to diminished levels of social protection for people with mental health needs. We also identify how discriminatory processes in the benefits system have negatively impacted the sense of self- respect and security experienced by claimants. Overall our data suggest that ESA and PIP processes undermine claimants’ subjective wellbeing and exacerbate experiences of mental distress. We therefore propose the term ‘benefits distress’ to describe these forms of suffering that are being institutionally propagated by UK government agencies and the corporations to which state welfare functions are outsourced. The study is part of the wider European RE-InVEST project to investigate the impact of active labour market and social protection policy on marginalised social groups since the financial crisis of 2007.
... This study supports the evidence of continued financial challenges to the cost of caring, which raises the question of the immoral state abdication of responsibility for caring for our most vulnerable members of society as it erodes accessibility to welfare entitlements (e.g., Personal Independence Payments) the precise benefits that are designed to cover the additional costs of caring (Roulstone, 2015). ...
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Accessible Summary • In the UK very few people with learning disability and/or autism and their family‐carers have a paid job although a lot of them may wish to work. National plans from the Government have not helped to change this. • This article talks about a consultation we did on adults with learning disabilities and/or autism who attend day centres and their family‐carers. We asked about their current situation, their employment and the barriers to work. • We found out that very few people with learning disabilities and/or autism or their family‐carers were employed. We found that there were lots of things stopping people with learning disabilities and/or autism and family‐carers from being able to work. • We conclude that disability theories like the “social model of disability” need to go back to looking at inclusion, citizenship and independence, based on the real life experience of people with a learning disability. The government needs to provide strong plans to help people with learning disabilities and/or autism and family‐carers get into work. “Co‐production” networks should be set up between people with learning disabilities and families to support employment. Abstract 1.1 Background Only 5.9% of working adults with a learning disability are in paid employment and their family‐carers are similarly likely to be unemployed, as they continue to take on an extended caring and advocacy role as the welfare state retreats. Despite social policy efforts to stimulate employment for people with a learning disability, there has been little or no progress. Changes in the language of welfare benefit departments seek to use the words once heralded as success for the Disability rights activists and proponents of the social model: such as Inclusion, independence and citizenship. A new definition of the social model of disability utilising Hannah Arendt needs to redefine the “private” sphere of the lived experience of people with a learning disability to allow for a better understanding of the inter‐dependencies that exist between people with a learning disability, their family carers and a wider support network. 1.2 Materials and Methods Empirical data were collected in a mixed methods study while undertaking a consultation on the future of day services for people with a learning disability in a Local Authority in the north of England, UK. 1.3 Results The results reveal high levels of inter‐dependence between people with a learning disability and their carers, combined with the continued financial struggle as a lived experience of caring. The study found that barriers in providing care and support restrict the rights of people with a learning disability and their carers to secure employment. 1.4 Conclusions There is a need to reconceptualise the social model of disability to more closely resonate with the lived experiences of people with a learning disability and their carers. A newly revised theoretical approach should incorporate the "private" sphere of live acknowledging the inter‐dependent, co‐produced relationships, between people with a learning disability and their carers to support and enable employment for both people with a learning disability and their carers under the Care Act 2014 (Department of Health, 2014).
... In addition, the recruitment purposefully targeted people who had made a claim for disability benefits in order to sample people who identified as disabled. However, disability social security rules cannot be assumed to provide an inclusive boundary for a construct of 'disabled people' (Roulstone 2015). Beatty and Fothergill (2015) highlight that many people who might previously have self-identified as disabled through the receipt of disability benefit may no longer do so and as such would have been excluded from this research. ...
This article seeks to examine the ways in which ‘work’ is a crucial domain within a holistic approach to understanding disability and family life. The research is based on the experiences of 49 people who either self-identified as disabled or were family members of a person with an impairment. The analysis focuses on the meaningfulness of work and argues that the meaning of work needs to be expanded in order to be more inclusive of disabled people. Issues of accessing and maintaining appropriate work and harmful work are also discussed. The research highlights the importance of work, both paid and unpaid, for disabled people and their families. However, the wrong kinds of work can have harmful consequences for disabled people and this needs to be acknowledged in policy focusing on access to work. • Points of interest • The study explores the experiences of paid work and non-involvement in paid work of disabled people and their families. • The participants discussed the value of different kinds of work for disabled people • The research highlights the importance of unpaid work for disabled people, including voluntary work and activism. • Some participants faced constraints accessing and maintaining appropriate work and careers • Some work and ways of working can be harmful to the health of disabled people • Disabled people and their families make significant contributions to society
... Since the introduction of disability living allowance (DLA) in 1992, the assessment of eligibility for disability-related social security payments in the UK has undergone several iterations. 1 Most recently there has been a large-scale overhaul of the existing system and a new replacement extra-costs disability benefit, the personal independence payment (PIP), has been introduced. ...
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Background Recent qualitative research suggests that changes to the way eligibility for welfare payments is determined in the UK may be detrimental to claimants with mental illnesses. No large-scale analysis has been undertaken to date. Aims To examine differences between claimants with psychiatric conditions compared with non-psychiatric conditions in the number of claims disallowed following a personal independence payment (PIP) eligibility assessment for existing disability living allowance (DLA) claimants. Method Administrative data on DLA claimants with psychiatric conditions transferring to PIP between 2013 and 2016 was compared with claimants with non-psychiatric conditions to explore differences in the number of claims disallowed following an eligibility assessment. Results Claimants with a mental illness were 2.40 (95% CI 2.36–2.44) times more likely to have their existing DLA entitlement removed following a PIP eligibility assessment than claimants with musculoskeletal conditions, neurological conditions and diabetes. Conclusions PIP eligibility assessment outcomes show marked differences by health condition, raising questions as to whether the process is equitable. Declaration of interest None.
... Claimants receive much negative media attention with the rhetoric of 'shirkers', 'scroungers' or 'cheats' (Briant, Watson & Philo, 2013;McEnhill & Byrne, 2014). It has been argued that the many television programmes about people on benefits (MacDonald, Shildrick & Furlong, 2014) cement the binary of 'good' and 'bad', or 'legitimate' and 'non-legitimate' disabled people (Roulstone, 2015). Other offensive terms such as 'scum', 'feckless' and 'work-shy' are also used (Garthwaite, 2011). ...
... (Model 6, Table 4). This is in spite of a shrinking category of disability in social security administration which has reduced the coverage and generosity of benefits for many affected by a disability (Roulstone, 2015). In part, we can see this reflected in the disproportionate growth (+23.2%) of those affected by a disability represented in the 2 nd decile of the income distribution (Table 2). ...
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Official statistics tend to rely on a headcount approach to poverty measurement, distinguishing ‘the poor’ from the ‘non-poor’ on the basis of an anchored threshold. Invariably, this does little to engage with the gradations of material hardship affecting those living, to varying degrees, below the poverty line. In response, this paper interrogates an apparent flatlining in UK poverty to establish the changing profile of poverty, as well as those most affected by it. Drawing on the Family Resources survey, this paper reveals an increasing depth of poverty in the UK since 2010, with bifurcation observable in the living standards of different percentile groups below the poverty line. In addition, this paper demonstrates substantial compositional changes in the socio-demographic profile of (deep) poverty. Since 2010, the likelihood of falling into deep poverty has increased for women, children, Black people, larger families and those in full-time work. Within the context of COVID-19, I argue there is a need to re-think how we currently conceptualise poverty by better attending to internal heterogeneity within the broader analytical and methodological category of ‘the poor’. Doing so raises pressing questions about the prevailing modes of poverty measurement that tend to frame and delimit the social scientific analysis of poverty, as well as the policies deemed appropriate in tackling it.
... The groups of people and their conditions that are contained in the category of 'disability' is fluid and has changed over time. 3 Recent shifts have broadened the scope, adding people with mental health conditions, intellectual disabilities, developmental disorders and sensory impairments. This is reflected in our anti-discrimination laws: the Equality Act 2010 defines disability as 'a physical or mental impairment which has a substantial and long-term adverse effect on the ability to carry out normal day-to-day activities'. ...
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This article examines the effects of UK welfare reform since 2008 on people with mental health conditions and disabilities. The results have been profound, particularly during a time of economic austerity, damaging the social safety net and pushing many vulnerable people into poverty and hardship. It has perpetuated inequalities and increased the social exclusion of disabled groups. The holes in the safety net require repair, alongside extensive social policy reform to both protect and empower people with disabilities and long-term conditions.
... She described the process of 'othering' where benefit claimants are often singled out as lazy, workshy or cheats. Roulstone (2015) believes that there are fundamental links between government policy and the way that disabled claimants are portrayed in the print and television media. Justifications for changes in policy are pushed through on the back of binary representations of people as being either 'legitimate' or 'non-legitimate' disabled people. ...
As part of the government’s programme of welfare reform Personal Independence Payment (PIP) is replacing Disability Living Allowance (DLA) for people of working age. This will have a significant impact on a wide range of disability benefit claimants. This article examines the government’s rationale for replacing DLA with PIP, the key technical differences between the two benefits and the role that disability benefits can play in reducing poverty. The introduction of PIP has led to considerable debate in the social welfare law sector about the scope, purpose and assessment of social security benefits for the disabled. These issues are explored with reference to the first Gray Review of PIP (2014) and the United Nations Committee on the Rights of Persons with Disabilities Inquiry (2016) into the impact of the UK Government’s policies on disabled people.
... First, economically, the costs related to disability have clearly and significantly been shifted from the individual and informal care sector to the state and public sector even though this is in part seen as a way of reducing public spending. This shift in itself is of significance considering that other countries (e.g., Great Britain) have lately been going in the opposite direction by retracting state expenses, notably by tightening eligibility criteria (Roulstone, 2015). As such, the policy represents a shift toward a "more family-oriented welfare state" (Johansson et al., 2011), that is, individuals will be less dependent on work and their families will be somewhat relieved of the costs related to disability. ...
In this article, we illustrate how Australia’s new National Disability Insurance Scheme (NDIS) extends the active citizenship of people with disabilities. This is done by examining how the NDIS changes their relation between persons with disabilities and to the welfare state, and through an analysis of its eligibility criteria and needs assessment planning. The support provided and the way in which it is provided reproduce a particular understanding of disability that has a direct influence on the roles assigned to people with disabilities in society as well as on their opportunities to exercise their rights as active citizens. This is important because the implementation of NDIS in Australia is likely to influence the development of disability policy on a global level. Understanding how its mechanisms restricts or facilitates citizenship is therefore crucial.
Child tax credit and universal credit provide means-tested support for low-income families. The government have introduced a two-child limit for these benefits meaning that the child element of child tax credit and universal credit will no longer be awarded for third or subsequent children born after 6 April 2017. The government argue that the benefit system should provide a fair deal for the tax payer and that families claiming benefits should face the same financial choices as those in work. However, it has been argued that there is an inherent moral injustice in linking benefit entitlement to the size of the family and that there will be an increase in child poverty. Firstly, this paper will discuss the ethics of limiting state financial support on the basis of family size with reference to how far social justice can be achieved in a ‘needs based’ benefits system. Secondly, there will be an analysis of the most controversial element of this policy – the so-called rape clause where an exception is applied if a claimant can demonstrate that their third or subsequent child is born as a result of non-consensual sexual intercourse. Finally, the paper will identify potential implications for anti-oppressive practice.
The Routledge Handbook of Critical Pedagogies for Social Work traverses new territory by providing a cutting-edge overview of the work of classic and contemporary theorists, in a way that expands their application and utility in social work education and practice; thus, providing a bridge between critical theory, philosophy, and social work. Each chapter showcases the work of a specific critical educational, philosophical and/or social theorist including: Henry Giroux, Michel Foucault, Cornelius Castoriadis, Herbert Marcuse, Paulo Freire, bell hooks, Joan Tronto, Iris Marion Young, Karl Marx, Antonio Gramsci and many others to elucidate the ways in which their key pedagogic concepts can be applied to specific aspects of social work education and practice. The text exhibits a range of research-based approaches to educating social work practitioners as agents of social change. It provides a robust and much needed, alternative paradigm to the technique-driven ‘conservative revolution’ currently being fostered by neoliberalism in both social work education and practice. The volume will be instructive for social work educators who aim to teach for social change, by assisting students to develop counter-hegemonic practices of resistance and agency, and reflecting on the pedagogic role of social work practice more widely. The volume holds relevance for both postgraduate and undergraduate/qualifying social work and human services courses around the world.
Aim: This article aims to explore how policymakers conceptualise a person suitable for disability income support (DIS) and how this compares across two settings – Australia and Canada. Methods: A constructivist grounded theory approach was used; 45 policymakers in Australia and Canada were interviewed between March 2012 and September 2013. All policymakers are or were influential in the design or assessment of DIS. Results: Results found that the policymakers in both jurisdictions define a suitable person as having as an ‘ideal type’ of disability with five features – visibility, diagnostic proof, permanency, recognition as a medical illness and perceived as externally caused. Many of the policymakers described how mental illnesses are not an ‘ideal type’ of disability for DIS by juxtaposing the features of mental illnesses against physical illnesses. As such, mental illnesses were labelled imperfect disabilities and physical illnesses as ‘ideal type’ for DIS. Conclusions: The rise of DIS recipients has divided the once protected ‘deserving’ category of the disabled into more (‘ideal type’ of disability) and less deserving (imperfect disability). Such conceptualisations are important because these categories can influence the allocation of welfare resources.
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The onslaught of neoliberalism, austerity measures and cuts, impact of climate change, protracted conflicts and ongoing refugee crisis, rise of far right and populist movements have all negatively impacted on disability. Yet, disabled people and their allies are fighting back and we urgently need to understand how, where and what they are doing, what they feel their challenges are and what their future needs will be. This comprehensive handbook emphasizes the importance of everyday disability activism and how activists across the world bring together a wide range of activism tactics and strategies. It also challenges the activist movements, transnational and emancipatory politics, as well as providing future directions for disability activism. With contributions from senior and emerging disability activists, academics, students and practitioners from around the globe, this handbook covers the following broad themes: • Contextualising disability activism in global activism • Neoliberalism and austerity in the global North • Rights, embodied resistance and disability activism • Belonging, identity and values: how to create diverse coalitions for rights • Reclaiming social positions, places and spaces • Social media, support and activism • Campus activism in higher education • Inclusive pedagogies, evidence and activist practices • Enabling human rights and policy • Challenges facing disability activism The Routledge Handbook of Disability Activism provides disability activists, students, academics, practitioners, development partners and policy makers with an authoritative framework for disability activism. Taylor & Francis 2019 Outstanding Handbook - Social Sciences - Award Winner
This article presents a key finding from a reflexive ethnographic study of the work disabled people and their support networks do to organize self-managed attendant services: that disabled ‘self-managers’ and their ‘attendant’ employees perform relational work to increase autonomy in the context of austerity-driven systemic constraints. Through a temporal lens informed by feminist and disability studies perspectives, ‘clock time’ was seen to obscure personal resources of energy, time and skill that self-managers and attendants contribute to the performance of relational work. ‘Crip time’ is explored as an alternative temporal orientation that might meaningfully inform future policy and programme development.
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This study aimed to provide insight into the experiences of and attitudes to sport and physical activity for disabled people. Data were generated through semi-structured interviews with eight facilitators and focus groups with 24 members across three disability support organisations. Using ableism as the primary sensitising concept, our iterative analysis revealed that although all facilitators and disabled people were aware of the physical and mental wellbeing benefits of sport and physical activity, only 2 of the 24 disabled participants met the UK Government guidelines for physical activity. Findings showed that participation was hampered by a number of external and internal barriers, including the cost of transport and activities, ineffective modes of communication and advertisement, preconceived images of sport as competitive and judgemental, and anxieties about sporting abilities. Importantly, this study highlighted that many of these barriers were a pretext for a lack of enjoyment, and makes suggestions for future practice.
Little scholarly work has focused on the lived experience of people claiming disability benefits. Drawing on semi‐structured interviews with 30 Jewish‐Israeli men and women with physical impairments, this paper seeks to fill this gap in the literature. Analysis of the interviews yielded three main themes: the material and psycho‐social aspects of the Israeli disability benefits system, respectively, and the coping strategies applied by the participants in their efforts to navigate the system and address their needs. The distinction between the first two themes is discussed as resonating with recent calls for an integrated disability justice conceptualization, one that entails both redistributive and recognitive aspects. The third theme is highlighted as countering the image of ‘passivity’ that is all too often associated with being on disability benefits.
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This study assessed the subjective well‐being and perceived stress of unpaid carers of disability benefit claimants. A total of 129 carers from the UK were surveyed between July and September 2017, using a cross‐sectional design. Carers, who provided unpaid support to sick or disabled friends, family or neighbours in a non‐professional capacity, reported here as unpaid carers, were asked to complete a web‐based questionnaire comprising of the Perceived Stress–10‐item Scale (PSS‐10), the Personal Wellbeing Index–Adult (PWI‐A), sociodemographic characteristics, the time they spent caring per day and the number of Personal Independence Payment and Work Capability Assessment interviews prepared for and attended by the person they cared for. Hierarchical regression analyses were performed to assess the effects of the number of benefit assessments on stress and well‐being scores, controlling for carers' sociodemographic characteristics and the time they spent caring. Analyses revealed that the number of times that claimants were exposed to benefit assessments significantly and negatively predicted unpaid carers' well‐being and was positively related to their stress levels. After controlling for sociodemographic characteristics and hours supporting per day, benefit assessments predicted 8.1% of perceived stress and 4.3% of well‐being variance. Being a female unpaid carer of a disability benefit claimant negatively predicted 7.5% of well‐being variance. The results offered unique evidence of the negative psychological effects of disability benefit assessments upon unpaid carers, while adding to the evidence of female carers facing increased risks of psychological distress.
Systematic literature searching identified 29 relevant health and social sciences articles for review on the topic of austerity policies and their impacts on the health and social care of disabled, elderly and immigrants in the United Kingdom (UK). Since 2010, government changes to previously state-funded areas meant levels of funding and eligibility changed significantly. Self-funding or self-managing healthcare, but more often social care, was transferred to individuals. While additional funding was given for some treatments, prevention approaches were cut. More people had to depend on non-professional care, mostly from family. Many family carers received no professional advice or information and mostly had to reduce their own employment hours and income to care for a dependent. The quality of services, professional or non-professional, became poorer than pre-2010. These changes increased marginalisation and stigma. Consequently, many ‘vulnerable’ became ‘vilified’ – disabled, elderly and immigrants often of the worst affected. • Points of interest • Government definitions of ‘disability’, ‘elderly’ and ‘immigrant’ change. UK changes reduced the health and social care available to individuals recently. • Individuals were made responsible for knowing about changes that affected them and had to manage their care without professional guidance and support. Some had to use personal funding to maintain their quality of life. • Many people felt stigmatised because of the changes and were nervous about seeking help they were entitled to. • Health and social care should be joined-up and involve assessment, funding, and services offered as a package. This should be ideally focused on preventing worsening health, early treatment and support for managing long-term conditions. • Judging that people currently contributing to the economy through work as those who deserve government services is wrong. Assisting the well-being of those who cannot currently contribute can recognise past contributions and improve potential to contribute, and may reduce future needs for government services.
The under-utilisation of the labour of disabled and older people is a problem across the European Union (EU) but is most pronounced in Central and Eastern European (CEE) member states, where labour shortages are greatest. This presents a puzzle that is explored with reference to a project with social partners from Estonia, Hungary and Poland, the objective of which was to stimulate debate and actions around the role of industrial relations actors in facilitating work accommodations for disabled and older people. After establishing the extent of the demographic labour crisis in these countries, the policy tools being employed to address it are scrutinised and found wanting. A variety of factors are identified as having contributed to debate in this area: historical legacy; social policy path-dependency; social partner identity and agency; a ‘dead letter’ approach to EU policies and the limited role of civil society organisations. We examine the potential of the concept of sustainable work, more commonly found in Northern Europe, to influence alternative approaches to the employment of disabled and older people in countries where state, labour and employment relations differ.
This paper reviews the history of parent advocacy in the UK on behalf of and with people with learning disabilities since the mid-twentieth century and reflects on the role of the academy in illuminating and documenting its story. It argues that parent advocacy has flourished at times of change and challenge, and has seen a revival since austerity began to bite. In the twenty-first century parent advocacy has mutated into working with, rather than for people with learning disabilities, a development to be welcomed, given the cuts to services, and the impact of ‘welfare reform’. This once more united voice is manifested in the launch of Learning Disability England in June 2016.
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Values such as ‘access’ and ‘inclusion’ are unquestioned in the contemporary educational landscape. But many methods of addressing these issues — installing signs, ramps, and accessible washrooms — frame disability only as a problem to be ‘fixed.’ The Question of Access investigates the social meanings of access in contemporary university life from the perspective of Cultural Disability Studies. Through narratives of struggle and analyses of policy and everyday practices, Tanya Titchkosky shows how interpretations of access reproduce conceptions of who belongs, where and when. Titchkosky examines how the bureaucratization of access issues has affected understandings of our lives together in social space. Representing ‘access’ as a beginning point for how disability can be rethought, rather than as a mere synonym for justice, The Question of Access allows readers to critically question their own implicit conceptions of disability, non-disability, and access.
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As witnessed by recent national policy battles over health care and climate change, the policy environment in the United States (U.S.) is increasingly politically polarized. U.S. public policy is progressively driven by divisive symbols and dominated by morality debates often articulated in the form of emotional narratives. One such issue that has gained attention in the U.S., partially due to efforts of First Lady Michelle Obama, is the increasing levels of obesity. Obesity policy advocates warn that the U.S. is facing a crisis that impacts not only our health, but our national competitiveness; not only our military preparedness, but our national security. Our goal is not to get involved in the scientific debate over obesity and its costs to society but rather to explore the role that policy narratives and causal attribution play in determining attitudes toward obesity and obesity policy. We contend that an individual's view of obesity is shaped by their view of individual rights and responsibilities and of individual morality; and determined more by stories (especially narratives that “fit” with those views) than by science. Our paper seeks to test whether science or other factors primarily shape one's view of government's appropriate role relative to the obesity issue and to examine which of two foundational moral narratives is more convincing in the obesity policy realm. Using a sample of 172 respondents at two institutions of higher education in the United States, we find that a “Strict Father Morality” narrative was more convincing than a science statement in influencing an individual's view of obesity. Respondents believed that obesity was a serious problem, but they were deeply divided over government's role in addressing the obesity issue. Female respondents were the most supportive of governmental efforts to address obesity. We explore the potential impact of our findings for public policy development and future research.
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Beatty C. and Fothergill S. (2005) The diversion from 'unemployment' to 'sickness' across British regions and districts, Regional Studies 39 , 837-854. Around 2.7 million non-employed adults of working age in the UK claim sickness-related benefits, and the numbers have risen steeply over time. The very large variation in the numbers across districts and regions points strongly to extensive hidden unemployment, especially in older industrial areas affected by job losses. This paper builds on two previous papers by the same authors - one dealing with the theoretical framework and the other with a local case study - to present wholly new estimates of the scale of the diversion across all parts of the country. It also questions contemporary perceptions of the UK labour market and the validity of current approaches to re-engaging sickness claimants with employment.
When we wrote the earlier edition of this book in 1974 it was necessary to argue the case for studying the social values and the social and political ideas of those who write about social welfare. That is now no longer the case. The study of values and social theories has come to be seen as central to the understanding of social policies. The structure of this revised book is the same as before. What we have done with each chapter is to review and revise it in the light of what has been written in recent years and in line with changes in our own ideas. Certainly, much has changed. The group we style the anti-collectivists has emerged from comparative obscurity to prominence in Britain and in other countries. New and important statements of anti-coUectivist principles and practice have been published, though very few of them have been implemented by governments.
With the Conservative Party breaking new ground in forming a coalition government with the Liberal Democrats, this book examines the development and content of the Conservatives' approaches to social policy and how they inform the Coalition's policies. Chapters cover the development of Conservative Party social policy and specific policy areas. The book will be of interest to academics, undergraduate and postgraduate students, and everyone with an interest in the Conservative Party and the Coalition government's social policies.
In an era of scarce social resources the question of the changing social policy constructions and responses to disabled people has become increasingly important. Paradoxically, some disabled people are realising new freedoms and choices never before envisioned, whilst others are prey to major retractions in public services and aggressive attempts to redefine who counts as 'genuinely disabled'. Understanding disability policy locates disability policy into broader social policy and welfare policy writings and goes beyond narrow statutory evaluations of welfare to embrace a range of indicators of disabled people's welfare. The book critically explores the roles of social security, social support, poverty, socio-economic status, community safety, official discourses and spatial change in shaping disabled people's opportunities. It also situates welfare and disability policy in the broader conceptual shifts to the social model of disability and its critics. Finally it explores the possible connection between changing official and academic constructions of disability and their implications for social policy in the 21st century. The book is supported by a companion website, containing additional materials for both students and lecturers using the book, which is available from the link above. © The Policy Press and the Social Policy Association 2012. All rights reserved.
The slow-down in the pace of accumulation has provided the opportunity for a widespread rejection of Keynesian political economy and an onslaught on the policies, values and organizations of social democracy. There has always been an element among British intellectuals which has never required much inducement to join a collective stampede to the right. We are constantly being told that 'intellectuals' are finally losing faith in socialism (this follows their previous final rejection of it in the early 1950s). They have been converted, even at this late hour, to the need to resist totalitarianism and the British Labour Party, and to reject the beliefs in collectivism and equality that were enshrined in the policies and institutions established in the 1940s. Aside from these 'men who have changed their minds', swayed by the populist clamour of the new right, there has also been in recent years a real intellectual change, a remarkable revival of liberal political economy through the elaboration of the doctrine of the social market economy, a doctrine which, under different labels, has made increasing headway within the Conservative party in the last ten years. The Conservative Government elected in 1979 had a group of ministers in the crucial economic ministries (Treasury, Industry, Trade, Energy), who were all adherents of the doctrine and prepared to govern in accordance with its prescriptions. The term social market economy originated in Germany from the neo-liberal ideas that were current there after 1945. In Britain and America similar ideas have been put forward by a number of theorists including F.A. Hayek and Milton Friedman, and popularized in Britain by organizations like the Institute for Economic Affairs and the Centre for Policy Studies, by lead writers in the Times and Daily Telegraph, by economic commentators such as Peter Jay, Samuel Brittan, and Patrick Hutber, and by Conservative politicians (Enoch Powell at first; more recently, Keith Joseph).
The recent history of the American welfare state has been viewed with dismay by those on the left because of the steady contraction of benefits under both Republican and Democratic administrations. In contrast, Jennifer L. Erkulwater describes the remarkable success of advocacy for the disabled at a time when the federal government was seemingly impervious to liberal policy innovations. Since the War on Poverty the American public's support for social-welfare policies has gradually eroded as conservative politicians have gained power and demographic changes and uncertain economic growth have enhanced pressures for fiscal retrenchment. Yet, the past thirty years have also seen a dramatic expansion of disability benefits. This book is the first to examine how entitlements for the disabled have fared in the wake of the disability-rights movement. This movement initially fought to end the institutionalization of the severely disabled and moved on to claim that antidiscrimination laws would allow the disabled to work and become less dependent on welfare. It also had a profound impact on entitlements. Erkulwater demonstrates that the Disability Insurance and Supplemental Security Income programs enacted between 1972 and 2000 succeeded because policy elites switched from welfare-based approaches to the civil-rights rhetoric used by the disability-rights movement. The work of liberal advocates who sought to end the segregation of the disabled in custodial institutions and integrate them into their home communities contributed to the growth of programs providing financial assistance to disabled citizens and to the recent controversies surrounding the future direction of disability policy.
Disability Living Allowance (DLA) was introduced in the United Kingdom explicitly to help offset the extra costs of disability. The scrapping of DLA and its replacement with the so-called Personal Independence Payment is causing massive concern across the United Kingdom, not least because it comes in the wake of a large number of other cuts, all of which impact disproportionately on disabled people. These changes reflect the retraction of ‘welfare’ across many European countries. As the government has refused to perform a cumulative impact assessment to date, it has been left to grassroots organisations such as DPAC to assess the damage and put the bigger picture together. An article in the New Statesman reports research showing that by 2018 disabled people are set to lose an astonishing £28.3 billion worth of financial support. These changes are going to affect up to 3.7 million disabled people in total.
The emergence of the ‘New Deal’ and its attendant claim to be part of a new political and social future based on the ‘third way’ seems to offer formerly excluded people new horizons for social inclusion. This paper provides a critical exploration of the likely impact of the ‘New Deal’ for disabled people. The paper contextualises the ‘New Deal’ in the wider ideology and rhetoric of ‘Welfare to Work’. In doing so, it highlights similarities between ‘New Deal’, ‘Welfare to Work’ and the victim blaming ideas which characterised discussions of a growing ‘social underclass' in the 1980s. By looking at the way the disability problem is framed within the ‘New Deal’ and ‘Welfare to Work’, it will be argued that it is unlikely to address the nature of employment barriers, indeed risks seriously misrepresenting the causes of disabled people's economic and social exclusion. In this way, its ideological underpinnings may simply reaffirm disabled people's economic and social dependency.
Background: In line with the NICE guidance, an NHS-commissioned case management intervention was provided for individuals receiving Incapacity Benefit payments for ≥3 years in the North East of England. The intervention aimed to improve the health of the participants. Methods: A total of 131 participants receiving the intervention were compared over 9 months with a (non-equivalent) comparison group of 229 receiving Incapacity Benefit payments and usual care. Health was measured using EQ-5D, EQ-VAS, SF-8, HADS and the Nordic Musculoskeletal questionnaire. Socio-demographic and health behaviour data were also collected. Fixed-effects linear models with correlated errors were used to compare health changes between groups over time. A preliminary cost-utility analysis was also conducted. Results: The comparison group measures of health were stable over time. Starting from comparatively poor initial levels, case-management group generic (EQ5D, EQ-VAS) and mental health (HADS-A, HADS-D and SF8-MCS) measures improved within 6 months to similar levels found in the comparison group. Musculoskeletal (Nordic 2) and health behaviours did not improve. Tentative estimates of cost-utility suggest an intervention cost in the region of £16 700-£23 500 per QALY. Conclusions: Case management interventions may improve the health of Incapacity Benefit recipients. Further research is required to help confirm these pilot findings.
Following establishment of the Conservative‐Liberal Democrat coalition, welfare benefits and those who receive them have become of increased significance, with the government and the media alike lamenting the amount of people receiving benefits and what could, and indeed should, be done about it. With a recent White Paper outlining a new Universal Credit, an integrated working age credit that will replace a range of benefits including the Employment Support Allowance for ill and disabled recipients, it means that once again sickness‐related benefits are back in the spotlight. This piece critically reflects upon the way people receiving sickness‐related benefits such as Incapacity Benefit and Employment Support Allowance can be labelled, portrayed and discussed within a wider rhetoric that encompasses governmental, public and media attitudes. Unfortunately, the impacts of such rhetoric could be counter‐productive with regards to employer responses to ill and disabled individuals. Yet policy remains centred largely on the supply rather than the demand side of labour. As a consequence, policies that target and highlight the functional limitations of individuals with perceived impairments are prioritised and supported at the expense of those which draw attention to and seek to resolve the stark inequalities of the social organisation of work.
An important policy issue in recent years concerns the number of people claiming disability benefits for reasons of incapacity for work. We distinguish between ‘work disability’, which may have its roots in economic and social circumstances, and ‘health disability’ which arises from clear diagnosed medical conditions. Although there is a link between work and health disability, economic conditions, and in particular the ‘business cycle’ and variations in the risk of unemployment over time and across localities, may play an important part in explaining both the stock of disability benefit claimants and inflows to and outflow from that stock. We employ a variety of cross?country and country?specific household panel data sets, as well as administrative data, to test whether disability benefit claims rise when unemployment is higher, and also to investigate the impact of unemployment rates on flows on and off the benefit rolls. We find strong evidence that local variations in unemployment have an important explanatory role for disability benefit receipt, with higher total enrolments, lower outflows from rolls and, often, higher inflows into disability rolls in regions and periods of above?average unemployment. Although general subjective measures of selfreported disability and longstanding illness are also positively associated with unemployment rates, inclusion of self?reported health measures does not eliminate the statistical relationship between unemployment rates and disability benefit receipt; indeed including general measures of health often strengthens that underlying relationship. Intriguingly, we also find some evidence from the United Kingdom and the United States that the prevalence of self?reported ‘objective’ specific indicators of disability are often pro?cyclical – that is, the incidence of specific forms of disability are pro?cyclical whereas claims for disability benefits given specific health conditions are counter?cyclical. Overall,
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